Records Officer Registration

Please complete the following form, then click "Next"

Salutation: 
First Name: 
Middle Name: 
Last Name: 
Suffix: 
E-mail Address*: 
Phone:  –  –   
Fax:  –  – 
Street Address: 
Address Line 2: 
City, State, Zip:   
Notification Method: 
Please Check One: I am an official records officer for a governmental entity, appointed by my chief administrative officer according to UCA 63A-12-103.
I am an employee of a governmental entity, but not an official records officer.
Describe Your Role: 
(max 200 characters)